Was this unprofessional from the nurses?

[twatmas]

Was in A&E last night / this morning for a horrible SVT run.
My veins are shot to pieces from years of bloods / cannulas / chemo so I know I'm hard to bleed.

Paramedics tried twice in the back of my hands but failed. (No blame there, I'm aware I'm hard to get a line into)
Got to hospital, and a nurse came along. I usually need the ultrasound to get a line in. I was happy for her to try a couple of times before asking for a machine. I did mention to her they usually need the US.

Anyway, after 5 goes in various different places (going over my already swollen sore hands from the paramedics) I started to get restless as it was hurting. I asked her if she could get an US machine as it was now hurting and I don't want to be prodded for the sake of it. She said no, she will keep trying.

6,7,8 goes, I was now bleeding out and my arms and hands were really painful blue. I was crying at this point as my chest was hurting and I was being poked and prodded from every direction. Going over repeatedly battered veins hurts. I said this to her, I apologised for being difficult to bleed but 9 times is too much. The nurse then said 'you've got to be brave, it's only a cannula, what do you want me to do?' And just shrugged.

This comment is what's pissed me off. I don't have a phobia of needles. I have had probably thousands at this point of those bastard things. I've had chemotherapy. I don't need to be brave. I don't need someone poking me 9 times. I need an US machine which could've saved so much time and pain.

I refused to have her try a 10th. A senior nurse came in quite disgruntled that I didn't let the previous nurse try again. He said to me 'well you've been through a lot but we need to get a cannula in.' Well yes, I agree. But not at the expense of battered and bruised arms. He tried for the 10th time, and managed to get the cannula in between my wrist and crook of my arm. Right in the middle of my arm. It fucking hurt, but it was in. I apologised again and thanked them, but they just seemed so annoyed with me.
This is NOT a nurse bashing thread. I have the utmost respect for them, but 10 attempts was horrible and I was made to feel like a wimp.
AIBU? Or is this standard practice?

I would not be happy with 10 goes, that is too many and you had already explained what normally worked. I would put in a complaint but explain that the outcome you would like is that real learning is taken from it so that other patients are heard when they explain what works. You might even offer to sit down with nursing staff to talk about your experience and how it feels as a patient. Hearing patient testimony can be very moving and effective for future practice.

They’d never have done this to a man and you’re not being unreasonable.

I bet they've never been pin cushions.

I think if you had got annoyed with them their attitude may have changed. Totally different scenario but when my sister was with my mum in hospital and was being spoken to in a way that's not acceptable she didn't get agitated, aggressive or raise her voice but somehow the way she responded clearly had an effect as the Dr's tone changed immediately.

Sometimes I get the impression that the more we apologise and try to be nice and considerate the more people walk over and treat you badly.

You are the expert in this situation having had to deal with it so many times, they should have respected your input.

I've only been cannulated a few times and one was a bloody mess. I couldn't feel anything but my husband was not happy at how badly it was done and felt it was an infection risk (he has family who are more your end with experience). I stopped him from complaining but I wouldn't have if they had been rude.

I think what @LatteLady suggested is a good idea.

Put in a complaint

That's awful. Cannulation can be very painful. They should have gone for the ultrasound machine, but were probably trying to save themselves the bother.

Someone will be along soon to tell you to be grateful 🙄
They had no right to be snippy.
You know your own body.

That’s madness. In our trust you can have two attempts, then someone with more experience can have two attempts, then we call the iv access team (or they get called after first two attempts if initial cannulator thinks it is too hard/painful for patient, or even first attempt if patient background necessitates). It would be an internal issue for that many attempts as you have to document attempts! Please complain, as that is really poor practice

That was not acceptable, I feel like with things like that some people get a bit ‘I know I can do it’ and try way more than they should. For me the worst was 4 tries and I outright firmly refused to let her touch me again.

I'm sorry you had this experience. That was appalling. They will have max number of attempts on their policy or standard operating procedure and it won't be 10. Obviously if you were imminently at risk of dying and there was no alternative method available in time then the risk / harm vs benefit balance would be different. Contact PALS. Hope you are better soon.

well i have seen many more attempts when my father was in hospital his record was 28 attempts before they put a central line in, i myself have had 18 attempts before a central line.

Op its horrible when they dont listen to what works for you.

You have my sincere sympathies, I'm also a nightmare for getting a needle into. After a horrendous experience with a Registrar who refused to admit defeat (and ended up using veins between my toes) I now have a golden rule for needles.

No one gets more than two attempts and they need to use a Paeds cannula because nothing else will do the trick. I explain it before they even attempt to get a needle in, and everyone has been great about it. They've still had to call phlebotomists on a couple of occasions but it has meant that no one keeps trying if they aren't successful on the second attempt.

Dreadful treatment. Not a criticism but i think you should have been more assertive.
Nurses are like any other profession, there are fabulous nurses and there are crap ones. Poor treatment needs to be picked up on

The reason they didn't get the US machine was because 'they're like gold dust.'
I was happy to wait for one..

I got the impression when I told the nurse I was difficult to cannulate and needed the US, that I was implying she's not good at her job. And it all went downhill from there really.

Thanks for the suggestions on what to do about It as well, I will definitely do that!

I’m very sorry this happened to you. I have ASD, an aversion to needles and very unrecognisable veins so I completely understand how unpleasant it is.

2attempts where I have worked and then get cannula team in .Also in Australia we always used local anaesthetic and the Aussies thought it barbaric that its not or wasn't routinely used here

That sounds horrible for you and not at all sympathetic of the nurse.
However - were you still in SVT? If so I can understand why the would have been keen to get access asap rather that wait to find a member of staff free to get a machine, find a machine (not always as easy as it should be), find someone trained to use it for cannulas etc.
From the sound of things A&Es are way beyond normal winter pressures right now and nobody seems to be getting an acceptable level of care - that’s terrible for patients but also terrible for the staff and I’m not surprised some are not at their best (doesn’t make it ok how they spoke to you still!).

Thank you, that's really good to know. I didn't know they had to be documented.

She put the needle in and out 3 times in the space or about 60 seconds, will that be out down as 3 attempts? Do you think they actually documented the 10 attempts? If so I will definitely say something.

Same policy in the hospital my mum was in (maybe the same one). They sent for a 3rd person (junior Dr) who had one quick go and said basically WTF, if Dr X can't do it then it can't be done and he had no idea why they didn't call for ultrasound straight away after the 2nd person as that was the policy. He sorted ultrasound and the cannula was in about 15 minutes later.

Complain.

That’s terrible, for both your father and you.

We don’t need to be the object of other people’s inability to admit defeat at the correct time.

Where i work it takes ages usually to be able to use the machine, but I would have told you this if it was the case rather than fobbing you off. We also have a max of 3 tries (less though if it's causing issues as this was) before getting another nurse to try or escalating; 10 times and leaving you in pain whilst dismissing your concerns is not on. They're either a crap nurse (they exist, we are but human), or as with more settings they're so super stretched staffing wise that they are doing what they can.

Either way though to you as a patient it's not acceptable, I would write a complaint, if it is due to short staffing then it's helpful to illustrate the effects (not that much gets done mind), and if they're just crap then it should be fed back to them so it doesn't happen again.

Hope you are feeling better soon.

No that’s not fair on you. I will only ever try twice, three times if I am certain I can get it on the third go (and the patient is keen to get it done quickly/happy for me to attempt again) before asking a colleague to try.

My arteries are hard to find for ABG. I refuse to let ST1 doctors ‘have a go’ at getting a sample. I need someone experienced, probably with an ultrasound, and I have made that pretty clear in the past.

Not acceptable at all. But I get they didn't want to get a cold light it US machine, because they didn't actually have one. We have a rule in paediatrics, if three stabs and you are out. And it gets escalated to someone more senior. (Rare for nurses to cannulate though)

As someone who cannulates people, I'm sorry she did this to you. Totally unacceptable. I do a maximum of two goes and then ask someone else to try. Particularly if the patient is saying they usually need an ultrasound! What a horrible nurse.

I’ve been in a similar situation and the nurse stopped after two attempts because she said she had to get a doctor, they are only allowed two. And the doctor said the same as a PP about getting the IV access team if he couldn’t get it on the second attempt.

Also please do complain properly - there’s a small chance the nurse was just rubbish in which case it won’t help much. However much more likely there are systemic issues related to availability of USS machine, poor staffing levels, overworked staff etc. Complaints coming from patients can make such a difference in changing things (even when staff have been raising concerns repeatedly).
I’m fairly certain that if there was a machine readily available, and staff free to fetch and use it, that she would have tried a couple of times then taken your advice. Also for the next patient it might be an emergency situation - and the machine being ‘like gold dust’ isn’t acceptable for an A&E!